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Haploidentical Hematopoietic Stem Cell Transplantation Patients With Wiskott-Aldrich Syndrome

Primary Purpose

Wiskott-Aldrich Syndrome

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hematopoietic stem cell transplantation
Miltenyi CliniMACS selection system
Fludarabine, Melphalan, Thiotepa
Sponsored by
St. Jude Children's Research Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Wiskott-Aldrich Syndrome focused on measuring Wiskott-Aldrich Syndrome, Immunodeficiency, Haploidentical transplantation

Eligibility Criteria

undefined - 18 Years (Child, Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria: Genotypical diagnosis of Wiskott-Aldrich Syndrome. Less than 18 years of age at time of transplant. Must meet two of the eight following clinical criteria: Eczema that is refractory to standard therapy. Thrombocytopenia as defined by a platelet count < 50,000/mm3. Significant risk for or presence of opportunistic infection. Autoimmune disease. Malignancy or pre-malignant condition. Family history as defined as a family member with WAS who died before 10 years of age. Does not have a suitable, available 6/6 HLA-matched sibling donor available for donation. Does not have a suitable, available 10/10 HLA-allele matched unrelated donor identified through the National Marrow Donor Program (NMDP). Exclusion Criteria: If any of the following clinical indicators are met within 45 days prior to transplant, the research participant will not be eligible for the study: Symptomatic cardiac disease or evidence of significant cardiac dysfunction by echocardiogram (shortening fraction < 30%). Creatinine clearance or Tc 99 less than or equal 40ml/min/1.73 m2. SGPT greater than or equal 500 U/L. Karnofsky or Lansky Performance Score of < 50. Pulmonary function tests: FVC < 50% of predicted value if age appropriate to perform the testing adequately or an O2 saturation less than or equal to 92% on room air at rest.

Sites / Locations

  • St. Jude Children's Research Hospital

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

1

Arm Description

Outcomes

Primary Outcome Measures

To determine safety in regards to engraftment and toxicity within 100 days post-haploidentical T- and B-cell depleted hematopoietic stem cell transplantation for patients with Wiskott-Aldrich syndrome who received a reduced intensity conditioning

Secondary Outcome Measures

Full Information

First Posted
September 8, 2005
Last Updated
April 24, 2017
Sponsor
St. Jude Children's Research Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT00160355
Brief Title
Haploidentical Hematopoietic Stem Cell Transplantation Patients With Wiskott-Aldrich Syndrome
Official Title
Haploidentical Hematopoietic Stem Cell Transplantation for Pediatric Patients With Wiskott-Aldrich Syndrome: A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
February 2009
Overall Recruitment Status
Completed
Study Start Date
May 2005 (undefined)
Primary Completion Date
July 2008 (Actual)
Study Completion Date
February 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
St. Jude Children's Research Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Wiskott - Aldrich syndrome (WAS) is a rare disorder curable only through allogeneic hematopoietic stem cell transplantation. A mismatched family member is an option when no human leukocyte antigen (HLA-immune system type) matched related or matched unrelated donor is available. This study will evaluate a novel therapeutic strategy for patients with WAS who undergo haploidentical transplantation using a parental donor. To reduce the risk of transplant-related toxicities, participants will receive a reduced intensity chemotherapy and antibody regimen (conditioning treatment). Participants will then receive an infusion of donor stem cells depleted of certain white blood cells called T- and B-lymphocytes. The stem cell depletion processing will be done through the use of the investigational CliniMACS device. A certain number of T-lymphocytes will be added back to the processed stem cell graft prior to infusion into the recipient. The primary objective of this study is to determine the safety of haploidentical transplantation in WAS patients using this specified conditioning regimen and engineered graft. Safety will be defined in terms of engraftment (meaning how well the graft grows and functions after infusion) and regimen-related toxicity within the first 100 days after transplant.
Detailed Description
Secondary Objectives in this trial include the following: To estimate the survival of study recipients at one year after infusion of the T- and B-lymphocyte depleted stem cell graft. To assess if the study treatment enables the recipient to generate normal donor-derived B-cell numbers and endogenous IgM, IgG, and IgA production, resulting in a reduction/elimination of the need for intravenous immunoglobulin infusions. To determine if the study treatment results in the ability of the research participant to generate normal donor-derived T cell response and natural killer (NK) cell numbers and function. To describe the incidence of Epstein-Barr virus-lymphoproliferative disease (EBV-LPD) in these transplant recipients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Wiskott-Aldrich Syndrome
Keywords
Wiskott-Aldrich Syndrome, Immunodeficiency, Haploidentical transplantation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Other
Intervention Type
Procedure
Intervention Name(s)
Hematopoietic stem cell transplantation
Other Intervention Name(s)
Haploidentical stem cell transplant, Allogeneic stem cell transplant, Mismatched family member donor transplant, T and B cell depletion
Intervention Description
To determine the safety in regards to engraftment and toxicity within 100 days of infusing a haploidentical T- and B-cell depleted hematopoietic stem cell graft into patients with Wiskott-Aldrich syndrome who have received a reduced intensity conditioning regimen.
Intervention Type
Device
Intervention Name(s)
Miltenyi CliniMACS selection system
Intervention Description
This system depletes the hematopoietic stem cell graft of T and B lymphocytes.
Intervention Type
Drug
Intervention Name(s)
Fludarabine, Melphalan, Thiotepa
Intervention Description
Participants will receive a reduced intensity conditioning regimen consisting of Fludarabine, Melphalan, Thiotepa, and OKT3 prior to receipt of the haploidentical stem cell graft. Rituximab will be given in an effort to prevent PTLPD. In addition to T-cell depletion of the donor product, cyclosporine will be given for GVHD prophylaxis.
Primary Outcome Measure Information:
Title
To determine safety in regards to engraftment and toxicity within 100 days post-haploidentical T- and B-cell depleted hematopoietic stem cell transplantation for patients with Wiskott-Aldrich syndrome who received a reduced intensity conditioning
Time Frame
March 2010

10. Eligibility

Sex
Male
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Genotypical diagnosis of Wiskott-Aldrich Syndrome. Less than 18 years of age at time of transplant. Must meet two of the eight following clinical criteria: Eczema that is refractory to standard therapy. Thrombocytopenia as defined by a platelet count < 50,000/mm3. Significant risk for or presence of opportunistic infection. Autoimmune disease. Malignancy or pre-malignant condition. Family history as defined as a family member with WAS who died before 10 years of age. Does not have a suitable, available 6/6 HLA-matched sibling donor available for donation. Does not have a suitable, available 10/10 HLA-allele matched unrelated donor identified through the National Marrow Donor Program (NMDP). Exclusion Criteria: If any of the following clinical indicators are met within 45 days prior to transplant, the research participant will not be eligible for the study: Symptomatic cardiac disease or evidence of significant cardiac dysfunction by echocardiogram (shortening fraction < 30%). Creatinine clearance or Tc 99 less than or equal 40ml/min/1.73 m2. SGPT greater than or equal 500 U/L. Karnofsky or Lansky Performance Score of < 50. Pulmonary function tests: FVC < 50% of predicted value if age appropriate to perform the testing adequately or an O2 saturation less than or equal to 92% on room air at rest.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kimberly Kasow, DO
Organizational Affiliation
St. Jude Children's Research Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Jude Children's Research Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.stjude.org
Description
St. Jude Children's Research Hospital

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Haploidentical Hematopoietic Stem Cell Transplantation Patients With Wiskott-Aldrich Syndrome

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